The development of modern endoscopic technology has enabled physicians to endoscopically view and excise or resect various organs, tumors and other matter contained within body cavities. Such endoscopic surgical procedures are typically performed by inserting an endoscope and the necessary operative instruments through minimal access incisions of approximately 1 cm in length. However, the organ, tumor or other matter which is excised or resected during such procedures is often too large to be removed from the body through the previously-formed minimal access incision(s). Thus, in order to remove such excised or resected matter from the body it is often necessary to either enlarge the size of the incision(s) or to reduce the size of the excised/resected matter, in order to facilitate its removal through the originally-formed minimal access incision(s). Included among the above-described endoscopic surgical procedures are various laparoscopic surgeries wherein a laparoscope and various instruments are inserted into the abdominal cavity through small abdominal incisions and are utilized to locate and excise or resect a diseased organ (e.g., gallbladder, uterus, bowel section, appendix, etc.), tumor and/or other matter (e.g., gallstones, uterine myomas, ovarian cysts, etc.) which is desired to be removed from the abdominal cavity.
In general, laparoscopic surgical procedures are conducted by initially inserting an inflation needle into the peritoneum and passing pressurized carbon dioxide through the inflation needle to create a distended pneumoperitoneum. Thereafter, a primary minimal access incision, such as a 1 cm incision or puncture, is formed in the periumbilical region of the abdominal wall. A primary laparoscopic portal or trocar is then inserted through such periumbilical puncture or incision. A laparoscope is then inserted into the pneumoperitoneum through the primary umbilical portal or trocar. One or more secondary trocars (i.e., "accessory portals") may also be inserted through additional incisions or punctures formed at secondary sites in the abdominal wall, to facilitate insertion into the abdomen and use of various operative instruments (e.g., blunt forceps, cutting instruments, cannulas, etc.). The operative instruments are then manipulated and utilized by the surgeon to perform the desired intra-abdominal surgical procedure while he/she views the procedure by way of the laparoscope. In some procedures, the laparoscope may be moved, during the course of the procedure, from the primary umbilical portal to an accessory trocar or portal, thereby freeing the primary portal for passage of additional instrumentation, and for subsequent use as a passageway for removal of the surgically excised tissue or matter. In recognition of the problem associated with removing tissue or matter from a body cavity through an incision or puncture which is smaller than the tissue or matter to be removed, the prior art has included a number of instruments designed to reduce the size of the tissue or matter within the body cavity in order to facilitate its extraction and removal through a relatively small minimal access incision or puncture. Examples of such prior art devices for intracorporeal reduction of tissue or other matter include those described in the following patents and patent publications: U.S. Pat. No. 4,324,262 (Hall), entitled Aspirating Culture Catheter And Method of Use; U.S. Pat. No. 4,368,734 (Banko), entitled Surgical Instrument; U.S. Pat. No. 5,074,867 (Wilk), entitled Surgical Instrument Assembly And Related Surgical Method; U.S. Pat. No. 5,076,276 (Sakurai et al.), entitled Ultrasound Type Treatment Apparatus; U. S. Pat. No. 5,190,561 (Graber), entitled Tissue And Organ Extractor; U.S. Pat. No. 5,215,521 (Cochran et al.), entitled Laparoscopy Organ Retrieval Apparatus And Procedure; U.S. Pat. No. 5,224,930 (Spaeth et al.), entitled Trocar System For Facilitating Passage Of Instruments Into A Body Cavity Through A Minimal Access Incision; U.S. Pat. No. 5,234,439 (Wilk et al.), entitled Method And Instrument Assembly For Removing Organ; U.S. Pat. No. 5,256,132 (Snyders), entitled Cardiac Assist Envelope For Endoscopic Application; U.S. Pat. No. 5,275,609 (Pingleton et al.), Surgical Cutting Instrument; U.S. Pat. No. 5,290,303 (Pingleton et al.), entitled Surgical Cutting Instrument; International Patent Nos. W0 92/11816 (Sorensen et al.), entitled Method And Device For Intracorporeal Liquidization Of Tissue And/Or Intracorporeal Fragmentation Of Calculi During Endoscopic Surgical Procedures; French Patent No., 1,272,412 (Kreie) entitled Catheter Uretral Avec Corbeille Expansible Pour L'Extraction De Calculs Renaux.
In particular, the prior art has included the laparoscopic morcellator described in U.S. Pat. No. 5,215,521 (Cochran et al.), entitled LAPAROSCOPY ORGAN RETRIEVAL APPARATUS AND PROCEDURE. The device described in U.S. Pat. No. 5,215,521 is purportedly useable to reduce tissue or other matter contained within an intracorporeally positioned entrapment envelope. The entrapment envelope comprises a flexible sac which is deployable into the body cavity. The entrapment envelope may incorporate wire guides or pneumatic means to facilitate opening of the envelope after it has been introduced into the body cavity. The organ, tissue or other matter to be removed is placed into the envelope, using manipulative instruments. The neck of the envelope is then exteriorized through the laparoscopic incision and the tissue morcellator device is inserted through the exteriorized neck of the envelope. The morcellator device described in U.S. Pat. No. 5,215,521 comprises an elongate tubular sheath which has a suction port on its proximal end and an open distal end. A drive shaft extends longitudinally through the morcellator sheath and is provided with a rotary cutting head on its distal end. The rotary cutting head is positioned within the open distal end of the tubular sheath. A drive means or hand crank is connected to the proximal end of the drive shaft to rotatably drive the drive shaft and cutting head within the surrounding tubular sheath. A suction side arm extends perpendicularly from a proximal portion of the tubular sheath. When suction is applied to the suction side arm, the reduced tissue fragments are aspirated through the space which exists between the inner wall of the tubular sheath and the rotating drive shaft which extends through the tubular sheath. Such tissue fragments are drawn out of the suction side arm, and into an attendant tissue containment canister. The application of vacuum through the tubular sheath ostensibly serves not only to aspirate the fragment tissue into the containment canister, but also to assist in bringing the organ or tissue into cutting contact with the rotating head, without requiring dangerous plunging motions of the morcellator device.
Despite the prior efforts to design tissue morcellation systems, there remains a need in the art for an improved high speed morcellation system that may be utilized to rapidly reduce and remove tissues which are tough in consistency (e.g., uterine myomas) as well as other tissues, tumors, organs or matter from anatomical passageways and/or body cavities. Also, there remains a need in the art for a tissue morcellator device which is capable of reducing and removing various tissues in pieces which are sufficiently large in size to permit adequate gross pathological evaluation.